The hurting middle class

Who is your neighbor? For most of us, it’s probably someone in the middle class – employed, maybe with a couple of kids and a dog, and increasingly likely to be uninsured or to struggle with paying out-of-pocket health care costs.

The middle class arguably has been squeezed the most by the rising cost of health care, says Jay Kieft.

Kieft, who is the director of Kandiyohi County Family Services, recounts the story of a local family who couldn’t afford employer-sponsored health insurance so they bought cheaper, high-deductible coverage instead. Then one of their children was severely hurt. Swamped by the resulting medical bills, this family ended up losing their home.

If you canvassed your neighborhood, you could probably find similar stories of ordinary people struggling to keep up with their health care expenses, Kieft told an audience today at Bethel Lutheran Church. It was the second in a month-long series of guest speakers on health care reform, organized by Bethel’s social ministries group to invite local conversation on how to fix health care.

There was so much food for thought in Kieft’s presentation that it would be impossible to cover it all. So instead I’ll share some of the highlights:

- There’s a safety net for the poorest of the poor, but the middle class – those earning a gross annual income of $44,000 to $88,000 – can generally expect little if any help paying for their health care coverage or health care expenses. Virtually none of them are eligible for assistance if they turn down employer-sponsored coverage because they can’t afford the premium.

For more context, consider this: Two-thirds of all jobs in Kandiyohi County pay less than $15 an hour. Health care premiums are rising at a faster rate than wages.

- The middle class is becoming uninsured at an accelerated rate. This report by the Kaiser Family Foundation found that nearly 25 percent of the non-elderly uninsured in the U.S. are from middle-class households. "To me that’s kind of an appalling number," Kieft said. "Where are their supports? How are they making up for the loss of health insurance?"

- As employers opt for higher deductibles and co-payments to rein in the cost of providing health coverage for their workers, how much of this burden can middle-class employees be expected to assume? Many working-age households are spending a growing proportion of their income on health care needs, especially if they are chronically ill.

- A growing number of people are skipping or postponing needed care because of the cost, Kieft said. When he asked for a show of hands on how many people in the Bethel audience had ever done this or knew of someone else who had, some hands were raised. "This is the United States of America. This is hard for me to accept," Kieft commented.

- Can we accomplish health care reform by tinkering at the margins rather than seeking wholesale change? Kieft’s opinion: Probably not. "It needs to be reform. It can’t be just a tweak here and a tweak there. We can’t complacently accept the status quo," he said.

- American attitudes about the health care system also need to change. People need to take some responsibility for the decisions they make, and not expect to pick and choose "like they’re in Wal-Mart," Kieft said. "We’ve got to examine that attitude if we want health care reform to work."

The next event in the Bethel series is at noon Wednesday, Aug. 19. It will feature Chris Conry of Health Care for America Now, with an overview of the health care reform bills under consideration by Congress. The last speaker on Aug. 26 will be Gary McDowell, administrator of Family Practice Medical Center in Willmar, on what this local clinic is doing to meet the challenges of the current health care environment.

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